Washington Debrief: ONC Reveals Stage 2 Vendor Readiness Data

The Office of the National Coordinator for Health IT revealed new analysis looking at vendor readiness on 2014 Edition CEHRT during this month’s Health IT Policy Committee. ONC’s Data Analytics team sought to answer the question, “What percentage of successful Meaningful Users attested with vendors that have passed certification for 2014 Edition CEHRT?” According to ONC’s findings, 66 percent of eligible professionals and 64 percent of eligible hospitals that have attested to Stage 1 Meaningful Use did so using a vendor that currently has a 2014 Edition product through certification. Government officials say this is significant because previous efforts to understand vendor readiness simply compared certified products between 2011 Edition and 2014 Edition CEHRT using ONC’s Certified Health IT Products List (CHPL). The new analysis reveals that the number of products listed on the CHPL over-represent the number products available and in use. For example, in the ambulatory market 40 percent of certified products have never been used in an attestation. For hospitals that number is closer to 50 percent; of 277 inpatient products listed, only 140 have had attestations, government officials said.

This analysis adds to a broader picture of readiness as many hospitals prepare for Stage 2 Meaningful Use, beginning October 1, 2013. CHIME has been a prominent voice in a campaign to get providers more time to meet Meaningful Use in 2014. While this data helps policymakers understand certain aspects of Stage 2 readiness, the question of implementation time remains yet to be answered. CHIME believes MU reporting periods should be extended by 12 months to ensure a safe, orderly transition to new technology that leaves no one behind. CHIME has been joined by HIMSS, AHA, AMA, MGMA and the AAFP is asking HHS for an extension to Stage 2 reporting periods in 2014 beyond the current deadline of July 2014.

Legislation & Politics

As Congress gets set to return from August recess, renewed focus will be given to the Sustainable Growth Rate (SGR) formula used to reimburse physicians participating in Medicare. Much promising work has been done by the House Ways & Means and Energy & Commerce Committees over the last several months. Paths forward on not just a temporary patch, but a permanent repeal of the SGR – and an eventual abandon of “fee-for-service” payment – has been outlined. But one key missing piece has been how to pay for such changes. With “debt ceiling” negotiations joining once again conversations around the sequester provisions of the budget control law, it is doubtful that Congress will easily find the $140 billion needed to repeal the SGR.

Hospitals will continue to be sensitive to this issue, especially as pay-fors enter the conversation. Washington observers and the Washington Debrief are primed to chronicle this story as Congress reconvenes for the Fall session.

Also during the Health IT Policy Committee meeting held recently, members of the HITPC accepted and approved recommendations from the Food and Drug Administration Safety and Innovation Act (FDASIA) working group for a risk-based regulatory framework for health information technology. The workgroup was charged with developing a framework that balance risk and innovation, while avoiding regulatory duplication among several government agencies, including the Food and Drug Administration (FDA), the Office of the National Coordinator for Health IT (ONC), and Federal Communications Commission (FCC). The workgroup said that health IT should not, as a general rule, be subject to pre-market regulation by the Food and Drug Administration, as many medical devices are today. However, some exceptions to that broad recommendation were identified, including, Software that serves as a medical device accessory could be regulated, as well as software systems that have artificial intelligence functions that present a high risk to the patient, such as systems that provide computer-assisted diagnoses. For all of the FDASIA workgroup recommendations, click here.

According to a blog posted by government officials, the next few months will see the FDA, ONC, and FCC reviewing the HIT Policy Committee’s recommendations and the public comments submitted through the docket we opened on regulations.gov. “Using these thoughtful inputs, ONC, FDA, and FCC will work closely together to develop a report (by the January 2014 statutory deadline) that proposes an overarching health IT regulatory strategy and provides recommendations on ways to appropriately promote innovation, protect patient safety, and avoid regulatory duplication.” The agencies plan to allow public input on the draft report following its publication in January.

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